American Journal of Epidemiology Vol. 131, No. 4: 669-682
Copyright © 1990 by The Johns Hopkins University School of Hygiene and Public Health
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RISK FACTORS FOR CERVICAL HUMAN PAPILLOMAVIRUS AND HERPES SIMPLEX VIRUS INFECTIONS IN GREENLAND AND DENMARK: A POPULATION-BASED STUDY
1Danish Cancer Society, Danish Cancer Registry, Institute of Cancer Epidemiology Rosenvaengets Hovedvej 35, Copenhagen, Denmark
2Nykøbing Faister Hospital, Department of Gynecology, Nykøbing Faister Denmark
3District Health Clinic Godthab, Greenland
4Rigahospitalet, Department of Pathology Copenhagen, Denmark
5Nykebing Falster Hospital, Department of Pathology, Nykabing Falater Denmark
6Statena Serum Institute, Enterovirus Department Copenhagen, Denmark
7German Cancer Research Center Heidelberg, Federal Republic of Germany
Reprint requests to Dr. Susanne Kruger Kjaer, Danish Cancer Society, Institute of Cancer Epidemi ology, Rosenvaengets Hovedvej 35, Box 839, 2100 Copenhagen, Denmark
Risk factors for genital human papillomavirus (HPV) types 6/11 and 16/18 and any HPV type as well as for herpes simplex virus type 2 (HSV-2) infections were investigated in a population-based study of 1,600 randomly selected women (20–39 years) from Godthäb (native, Nuuk), Greenland, and Nykebing Falster, Denmark. A total of 586 Greenlandlc women and 681 Danish women were Included, respectively. They all had a personal interview and a gynecologic examination with cervical smear and swab for HPV analysis (filter in situ hybrid Ization). Moreover, a blood sample was obtained for analysis for HSV-2 antibodies by enzyme-linked immunosorbent assay. In view of the general concept of HPV as a sexually transmitted vIrus, ft Is unexpected that women with "multiple" partners revealed a significantly lower risk for all types of HPV than did women with "few" partners, the odds ratio (OR) being 40-60% decreased in women with 2O partners compared with women who had 0-4 sexual partners. In contrast, the risk for HSV-2 infection was significantly increased among women with early age at first sexual intercourse (OR=2.9 for age 
13 ys. 14–16 years) and multiple partners (OR=2.8 for 
20 vs. 0–4 partners) (hereafter referred to as "high sexual activity" as well as with an increasing number of sexually active years with an unprotected cervix (i.e., without the use of barrier contraceptives) (OR=2.0 for R15 vs. 0–9 years). The results of this study thus demonstrate a surprising risk pattern for HPV types 6/11 and 16/18, but a pattern for HSV-2 in line with that to be expected for a sexually transmitted virus. This could indicate the existence of factors, especially In women with high sexual activity, which interfere with the expression of HPV or with the ability to detect it and/or that HPV may be transmitted by means other than sexual contact.
condylomata acuminata; contraceptives, oral; hubridization; sex behaviour; sexually transmitted diseases; smoking; vaginal smears
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